Cord Blood Cardiac Troponin T and Nonprotein-Bound Iron Levels in Newborns of Mild Pre-Eclamptic Mothers

Abstract

Background: In hypoxic newborns, cardiac troponin T (cTnT) was shown to be an indicator of cardiac damage and increased levels of nonprotein-bound iron (NPBI), an indicator of increased free radical production and perinatal brain damage. Objective: The aim of this study was to determine cord blood cTnT and NPBI levels in neonates of mild pre-eclamptic mothers. Methods: The study included 50 babies of mild pre-eclamptic mothers and 50 babies of healthy mothers. cTnT and NPBI levels were measured in cord blood. Results: The mean gestational age in the pre-eclamptic and healthy groups were 36.1 ± 3.5 and 38.1 ± 1.9 weeks, mean birth weights were 2,456 ± 945 and 3,059 ± 493 g. Cord blood median cTnT level was significantly higher in the pre-eclamptic group (0.024 vs. 0.015 ng/ml). Serum cTnT in the 95th percentile was 0.047 ng/ml in the healthy group. cTnT levels of preterm babies in the pre-eclamptic group was found to be significantly higher compared to term babies in the control group (0.038 vs. 0.013 ng/ml). It could not be demonstrated whether there is a statistically significant relation between cTnT levels and respiratory distress, gestation, type of delivery, sex and birth weight. The median NPBI level was higher in the control group (3.26 vs. 1.86 µmol/l). Conclusions: Increased levels of cTnT may be a biochemical marker of cardiac involvement in babies of mild pre-eclamptic mothers. In this study, no correlation was found between cTnT levels and NPBI levels.

Neural and cardiac injury markers in fetal growth restriction and their relation to perinatal outcomes

“…Although our study supports the existing data linking troponin T and gestational age at delivery, birth weight, APGAR scores, and umbilical artery Doppler PI, Karadeniz et al (14) . certified no relationship between troponin T and gestational age or birth weight in fetuses with mild pre-eclampsia.…”

Fetal tissue Doppler imaging in pregnancies complicated with preeclampsia with or without intrauterine growth restriction

“…Several studies suggested biochemical changes in preeclampsia or IUGR: Karadeniz et al . reported that increased levels of cardiac troponin T (cTnT) in cord blood may be a biochemical marker of cardiac involvement in babies of mild preeclampsia; modified‐myocardial performance index, blood B‐type natriuretic peptide, and early‐to‐late diastolic filling ratios were increased in IUGR fetuses in a stage‐dependent manner; SGA infants had detectable cardiac troponin I in umbilical cord blood, which may predispose to the development of adult premature cardiovascular disease and death . To our knowledge, there are few related reports on the potential TDI appliance in co‐effect of preeclampsia and IUGR on fetal cardiac function, despite that Comas et al .…”

“…3 A growing body of evidence suggests that fetal cardiac impairment may be evident in preeclampsia; several investigators have previously documented the presence of fetal cardiac dysfunction [4][5][6] and increased cardiac troponin T in cord blood in preeclampsia. 7 Also, cardiac dysfunction may continue during postnatal life, with reports that children born from pregnancies complicated by preeclampsia may demonstrate cardiac dysfunction from ages 5 to 8 years old. 8 It is unclear whether IUGR has a synergistic effect with preeclampsia on cardiac dysfunction.…”

Use of cardiac biomarkers in neonatology

“…Tocolytic therapy with β-sympathomimetics was related to an elevation in cTnT in the neonate (39). Elevated levels of cTnT were found in infants born to mothers who experienced preeclampsia, thereby associating maternal disease with neonatal myocyte compromise (40). Makikallio et al found that cTnT levels were elevated in infants born after severe placental insufficiency, although other studies failed to show an increase in cTnI levels during intrauterine growth restriction (35,41).…”